Objective To study the characteristics of percutaneous transluminal angioplasty(PTA) and its curative effect on lower limb arteriosclerosis in elderly patients with TASC H -D lesions. Methods Fifty elderly patients(64 limbs) with lower limb arteriosclerotic TASC II -D lesions underwent PTA in our hospital. Its curative effect,complications and follow-up data were analyzed. Results Of the 64 limbs,58 were successfully treated with a success rate of 90. 6% (58/64). Of these 58 limbs, 10 underwent simple balloon dilation and 48 underwent combined balloon dilation and stenting. Complications occurred in 5 patients (10. 0%)during perioperative period (including pseudoaneurysm in 1 patient, heart failure in 1 patient,contrast-induced nephropathy in 1 patient and artery perforation in 2 patients). No patient died during perioperative period. The Doppler an-kle-brachial index(ABI) was higher at 1 week after operation than before operation(0. 78 + 0. 14 vs 0.40 + 0. 11,P<0. 001). Fifty and 30 limbs were followed up at 12 and 24 months, respectively, after operation, with a primary patency rate of 84. 0% (42/50)and 66. 7% (20/30) respectively and a secondary patency rate of 88. 0%(44/50)and 76. 7% (23/30) respectively. The 24-month limb salvage rate was 100% (30/30). Conclusion PTA for lower limb arteriosclerotic TASC II -D lesions can achieve a high success rate and a high limb salvage rate with few complications and good short term clinical outcomes. However,its long-term curative effect needs to be further observed.%目的 探讨老年下肢动脉硬化泛大西洋介入学会(TASC)Ⅱ-D级病变患者腔内治疗的技术特点及疗效.方法 选取50例我院收治并进行腔内治疗的老年下肢动脉硬化TASCⅡ-D级病变患者(64条下肢),对腔内治疗的技术方法、疗效、并发症、术后随访等进行总结分析.结果 成功进行腔内治疗58条下肢,技术成功率90.6％(58/64),其中单纯行球囊扩张10条下肢,球囊扩张联合支架置入48条下肢.围手术期发生并发症5例,发生率为10.0％(5/50),包括穿刺处假性动脉瘤形成1例、心力衰竭1例、造影剂肾病1例、动脉穿孔2例.围手术期无死亡患者,术前与术后7d踝肱指数比较,差异有统计学意义(0.40±0.11 vs 0.78±0.14,P＜0.001).术后12、24个月分别随访50条和30条下肢,Ⅰ期通畅率分别为84.0％(42/50)和66.7％(20/30),Ⅱ期通畅率分别为88.0％(44/50)和76.7％(23/30),24个月保肢率为100％(30/30).结论 对老年患者下肢动脉硬化TASCⅡ-D级病变进行腔内治疗,技术成功率高、保肢率高、并发症少、近期临床效果良好,远期疗效需继续观察.
展开▼
